When I completed my Ketamine-Assisted Therapy certification, I experienced the single worst thing that can happen to a therapist during an altered-state training: I was left alone, unheld, and essentially abandoned at the most vulnerable moment of the experience.
We were working in dyads. As I was coming out of my ketamine journey, still disoriented, still in that liminal space where you need grounding, attunement, and safety, the facilitators approached me and asked for consent to take my partner away.
Anyone trained in psychedelic-assisted therapy knows:
You don’t ask someone under ketamine for consent to remove their support.
You especially don’t break a dyad that you told participants must remain intact.
But they did. And then they walked away.
Meanwhile, another participant had been yelling through the entire session — clearly in distress — and rather than removing her or attending to her in a trauma-informed, private, regulated way, they left the entire group to be disrupted for the duration of the session. Her experience was not the problem — the lack of containment was.
Later I learned the facilitators “had never encountered such a disruption” and “didn’t know how to handle it.”
Yet we were told repeatedly about their extensive experience.
When I brought my experience to the person running the training, the one with the authority, the one who preached the importance of set and setting, she simply said:
“I saw the whole thing happening.”
And that was it. No attunement. No accountability. No repair. No follow-up.
Just the acknowledgment that she watched it all unfold and chose to do nothing.
What followed for me was a real attachment rupture in a setting where safety and containment are supposed to be the foundation. In psychedelic work, the facilitator is the secure base. When that base collapses, the entire experience can feel destabilizing.
It became painfully clear that the leader of the program was more interested in being known as a figure in the psychedelic community than actually upholding the ethics they teach.
This is exactly what is wrong with the psychedelic field right now:
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People are teaching protocols they don’t embody.
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Facilitators are praised for their persona, not their capacity to hold a room.
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Trainings emphasize theory while ignoring the essential interpersonal skill of repair.
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There is often no accountability system when harm occurs.
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“Set and setting” becomes a slide on a PowerPoint instead of an ethical responsibility.
Psychedelic-assisted therapy can be deeply healing.
But without true containment, trauma-informed leadership, and the ability to navigate rupture and repair, these trainings can inadvertently cause harm to the very clinicians trying to learn how to protect others.
This is why we need:
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More trauma-informed leadership in psychedelic training programs
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Facilitators who can actually manage dysregulation in the room
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True accountability and follow-up when something goes wrong
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Less ego, more ethics
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Set and setting that are actually held not just talked about
My experience didn’t turn me away from the work.
But it made one thing unmistakably clear:
Psychedelic therapy is only as safe as the people holding the container.
And far too often, the container isn’t being held at all.
